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Lecture 01: General Overview, Anatomical Terminology, Structure

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Lecture 01: General Overview, Anatomical Terminology, Structure General Overview Anatomical Terminology, Structure & Function of the MSK System Objectives 1. Define the key functions of the MSK system. 2. Demonstrate the anatomical position, and relate anatomical terms to this position. 3. Identify the 3 primary planes/axes about which movements of the body occur. 4. Identify the 4 types of tissue that comprise the MSK system and distinguish between their structural organization. 5. Describe specific functions associated with each type of tissue, and identify factors/parameters that may influence their function. Basic Structural Components 1. Bone 2. Muscle 3. Tendons & Ligaments 4. Joints - Cartilage (hyaline, fibro cartilage) - Vascular system – localized blood flow - Nervous system – afferent / efferent conduction General Functions of MSK System 1. Support 2. Protect 3. Move 4. Store **Influenced By a Host of Variables** Terms of Reference Anatomical Position • What is it?? – Is the universal standard posture of reference • Standing facing forward • Feet shoulder width apart • Arms at the side and palms facing forward – All reference to anatomical landmarks – All movement begins from this position. Superior / Inferior: - towards the head/foot; sometimes referred to as Cephalad/ Caudal Anterior/ Posterior - front/back; sometimes referred to as Ventral/ Dorsal Medial / Lateral - towards the midline / away from the midline Proximal / Distal: - closer / further Superficial / Deep - Close to the surface / Away from the surface Plantar / Dorsal - sole of the foot / top of the foot Palmar / Dorsal - Palm of the hand / top of the hand Planes • An Anatomical Plane is a definitional term used to provide orientation to the body when you are observing it as a whole or the parts. Each plane can best be described as a sheet of glass that passes through the body, dividing it into 2 sections. • In human anatomy, there are three basic planes.1. The Frontal (or coronal) plane; 2. The Sagittal (or median) plane; 3. The transverse (or horizontal) plane. Sagittal Plane • The Sagittal (or median) plane runs through the body from front to back and divides the body into left and right Frontal Plane • The Frontal (or coronal) plane runs through the body from left to right and divides the body anterior from posterior; Transverse Plane • The transverse (or horizontal) plane runs through the body as a cross sectional plane, dividing the body into superior from inferior sections. transverse Axis of Movement • Movements of the human body are described as occurring about 3 primary axes of rotation. • Determined by the joint that is moving. • As a general rule, each axis of rotation is named for the anatomical plane that it runs perpendicular to. Frontal Axis = shoulder flexion Longitudinal Axis = medial shoulder rotation Sagittal Axis = shoulder abduction Types of Movement • Described in oppositional pairs •Flexion decreases the angle between two bones •Extension increases the angle between two bones • Rule #1 Flexion is any movement towards the fetal position whereas extension is any movement away from the fetal position • Rule #2 Don’t forget rule #1 Types of Movement (cont’d) • Flexion / Extension /Hyperextension • Abduction / Adduction • Medial / Lateral Rotation • Dorsi flexion / Plantar flexion • Pronation / Supination • Eversion / Inversion Types of Movement (cont’d) • Shoulder Elevation / Depression • Retraction / Protraction • Circumduction / Composite movements You must ALWAYS identify joint where the movement occurs i.e. flexion of the wrist, abduction of the hip Bone • Among body’s hardest structures – Only dentin and enamel in teeth are harder • Highly vascular • Very dynamic and metabolically active – Excellent self repair capacity – Constantly remodeling – Can easily change its properties and configuration in response to mechanical load Bone Function • Support • Movement • Storage of RBC • Protection • Mineral storage (calcium) • Energy storage (fat) Types of Bone • Four principal types according to shape Long bones (femur/humerus) Short bones (carpels/metacarpels) Irregular bones (vertebrae) Flat bones (skull) Sesamoid bones (knee cap) Bone Composition • Specialized CT • Consists of – Organic extracellular matrix – Inorganic materials (minerals that make bone hard & rigid) • Exact composition dependent upon: – Age – Location – Diet – Disease Organic Component - Collagen • Type 1 collagen makes up 90% of extracellular matrix (ECM), and accounts for 25 – 30% of bones dry weight • Gelatinous ground substance surrounds collagen fibers and serves as a “cement like” substance that holds collagen together. Constitute 5% of ECM • Water – 85% found in ECM • Bone cells Inorganic Component - Minerals • Calcium • Phosphate • Account for 60 – 70% of bones dry weight • Embedded in fibers of collagen organized along patterns of stress • Gives bone its solid consistency 4 Types of Bone Cells • Osteoprogenitor cells: – located on the external surface of bone – Divide and proliferate to form osteoblasts • Osteoblasts – Responsible for mineralization of boney matrix – Respond to stimuli and allow bone to remodel – When completely surrounded by osteoid matrix it becomes an osteocyte • Osteocyte – Center piece of boney matrix – Synthesize and resorb boney matrix to control blood calcium levels • Osteoclasts – Phagocytic cell from bone marrow – Responsible for bone breakdown and removal Types of Bone • Cortical (Compact): – Forms outer shell of bone (cortex) – Very dense structure – Always surrounds Cancellous bone, but thickness varies depending on type of bone, age, diet, and functional requirements • Cancellous (Trabecular): – Inside of bone – Thin plates arranged in a loose mesh structure – Arranged in a concentric layers with marrow between Bone Development • All bones formed from mesenchyme • Types of ossification 1. Intramembranous - Bone forms directly from mesenchyme during embryonic period 2. Endochondral – Cartilaginous bone formation – Primary vs. secondary ossification centers – Diaphysis / metaphysis / epiphysis Long Bone Structure – 4 components 1. Bone Cortex The outer rim of bone surrounding the medullar cavity (dense bone) 2. Medulla The inner cavity with the bony shaft Contains the bony marrow: Red (blood production) and Yellow ( fat storage) 3. Periosteum A dense white fibrous layer surrounding the cortex of the bone. Contains blood and nerve supply to the bone Also has osteoblasts and osteoclasts which promote ongoing bone growth and remodeling 4. Endosteum The inner lining of the medullary cavity Contains osteoblasts and osteoclasts to promote ongoing bone growth and remodelling. Bone Growth & Regeneration dependent on: • Size • Depth • Location • Maturity Various Loading Modes of Bone “Anisotropic” Nature of Bone Strongest when stress occurs along the long axis of a bone. Therefore the direction that stress is applied determines the strength of the bone. Point of no return – where injury occurs Fractures: (dependent upon…….) 1. Muscle contraction: - Increases bone strength - Alters the stress distribution - Decrease or eliminate tensile stress on bone by producing compressive stress 2. Viscoelastic Nature - Strength varies with the rate it is loaded - Stiffer when loads applied at high rates; but also stores more energy. - Bone is strongest when forces applied along the long axis of bone are compression or tension Fractures: (dependent upon…….) 3. Fatigue rate determined by: - Amount of load - # of repetitions - # of repetitions in a given time period (frequency of load) 4. Bone geometry: Load to failure and stiffness are proportional: - PCSA of bone - Distribution of bone around a central axis - Length of bone - A Stress Raiser can occurs surgically when a piece of bone is removed or a screw is inserted. Fracture Healing Bone Remodeling • Wolff’s Law – remodeling of bone is influenced and modulated by mechanical stress • Bone will alter its size, shape and structure to meet the mechanical demands placed on it. • Accomplished by either: – Gravity (influenced by body weight) – Muscle activity • Careful consideration during facture healing: – Length & method of immobilization – Impact of metal implants Skeletal Muscle • Most abundant tissue in body (45% of TBW) • 430 skeletal muscles found in pairs • Key movements executed by fewer than 80 on the pairs • Functions to provide strength & protection to the skeleton by distributing loads and absorbing shock; maintain body posture; move bones at joints • Performs both static & dynamic work Muscle Function 1. Joint stability 2. Joint motion 3. Postural control 4. Force absorption Skeletal Muscle Structure & Organization Muscle Fiber (Groups of Myofibrils) Basement Satellite Cell Sarcoplasm Membrane Sarcolemma Adapted from Alberts et al, 2002 Cytoskeleton reinforces the Dystrophin, Spectrin sarcolemma Desmin, Vimentin & holds the myofibrils in place Myofibril – Groups of Sarcomeres Ross, 2003 Contractile & Structural Proteins Musculotendinous Unit Series Elastic Bone Component Parallel Elastic Component Bone Musculotendinous Unit Series & Parallel Elastic Component SEC = Muscle Length PEC = Muscle width Muscle Function Influenced by a Host of Factors 1. Muscle architecture 2. Type of contraction 3. Type of movement 4. Speed of contraction 5. Position of muscle 6. Other factors – Fiber type – Muscle temperature – Muscle fatigue – Pre-stretching of muscle Muscle Architecture Muscles are Built for Different Things Lieber & Fowler, 1993 Strength vs. Flexibility Fiber Length(FL) Muscle Length(ML) Physiological Cross Sectional Area (PCSA) Lieber, 2002
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